Endocrine Abstracts

Objective

The objective of this systematic review was to assess the proportion of patients with prolactinomas that obtain remission or experience adverse effects after transsphenoidal surgery.

Design

A systematic review. Registered at PROSPERO, registration number CRD42020213002

Methods

A bibliographical search of PubMed and Embase was performed and last updated on September 30, 2020. Eligible studies were studies that included patients who had undergone transsphenoidal surgery for prolactinomas. A random effects analysis was used to calculate the weighted proportions.

Results

Sixty-five observational studies assessing the effect of transsphenoidal surgery for prolactinomas in 4472 patients, were included. The overall proportion of patients obtaining remission after surgery was 61% (95% CI 56 to 65; I^{2 =} 84%), while the proportion of patients with microprolactinomas and macroprolactinomas obtaining remission was 79.8% (95% CI. 74 to 85) and 52.7% (95% CI. 44 to 61), respectively. Patient mortality was reported as 0% in 14 studies with 1413 participants. Meningitis was observed in 2.7% and postoperative CSF leakage in 4.4%.

Conclusion

This systematic review found an overall remission rate across a range of studies to be 61% (95% CI 56 to 65), and a remission rate for microprolactinomas of 79.8% (95% CI 74 to 85) after transsphenoidal surgery. There are few reported side effects and giving the improving results of transsphenoidal surgery it could be considered first line treatment in selected cases.